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<p>In 2020 a significant threat to public health emerged. The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic outbreak emerged in December 2019 from Wuhan City, Hubei Province, China and spread to the rest of the world. This disease was named COVID-19 by World Health Organization. To date (17<sup>th</sup> April 2020) a total of 2,230,439 cases of COVID-19; 150,810 cases of deaths and 564,210 recovered cases have been reported worldwide. In this review the SARS-CoV-2 morphology, pathogenic mechanism, similarities and differences between SARS-CoV and Middle East Respiratory Syndrome and severe acute respiratory syndrome, transmission mode, diagnosis, treatment, and preventive measures were investigated. The outbreak of COVID-19 from a Malaysian perspective was explored and mental health care during the COVID-19 outbreak was explored. To date, there is no vaccine or no specific treatment for COVID-19. Therefore, preventive measures are very important to prevent and control the rapid spread of the SARS-CoV-2 virus. Preparedness should be a priority for future pandemic outbreaks.</p>
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<sec><b>Objectives</b>
<p>Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, China, in December 2019 and has been rapidly spreading worldwide. Although the causal relationship among mutations and the features of SARS-CoV-2 such as rapid transmission, pathogenicity, and tropism, remains unclear, our results of genomic mutations in SARS-CoV-2 may help to interpret the interaction between genomic characterization in SARS-CoV-2 and infectivity with the host.</p></sec>
<sec><b>Methods</b>
<p>A total of 4,254 genomic sequences of SARS-CoV-2 were collected from the Global Initiative on Sharing all Influenza Data (GISAID). Multiple sequence alignment for phylogenetic analysis and comparative genomic approach for mutation analysis were conducted using Molecular Evolutionary Genetics Analysis (MEGA), and an in-house program based on Perl language, respectively.</p></sec>
<sec><b>Results</b>
<p>Phylogenetic analysis of SARS-CoV-2 strains indicated that there were 3 major clades including S, V, and G, and 2 subclades (G.1 and G.2). There were 767 types of synonymous and 1,352 types of non-synonymous mutation. ORF1a, ORF1b, S, and N genes were detected at high frequency, whereas ORF7b and E genes exhibited low frequency. In the receptor-binding domain (RBD) of the S gene, 11 non-synonymous mutations were observed in the region adjacent to the angiotensin converting enzyme 2 (ACE2) binding site.</p></sec>
<sec><b>Conclusion</b>
<p>It has been reported that the rapid infectivity and transmission of SARS-CoV-2 associated with host receptor affinity are derived from several mutations in its genes. Without these genetic mutations to enhance evolutionary adaptation, species recognition, host receptor affinity, and pathogenicity, it would not survive. It is expected that our results could provide an important clue in understanding the genomic characteristics of SARS-CoV-2.</p></sec>
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Osong Public Health Res Perspect 2020;11(3):112-117. Published online May 8, 2020
<sec><b>Objectives</b>
<p>Coronavirus Disease-19 (COVID-19) is a respiratory infection characterized by the main symptoms of pneumonia and fever. It is caused by the novel coronavirus severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2), which is known to spread via respiratory droplets. We aimed to determine the rate and likelihood of SARS-CoV-2 transmission from COVID-19 patients through non-respiratory routes.</p></sec>
<sec><b>Methods</b>
<p>Serum, urine, and stool samples were collected from 74 hospitalized patients diagnosed with COVID-19 based on the detection of SARS-CoV-2 in respiratory samples. The SARS-CoV-2 RNA genome was extracted from each specimen and real-time reverse transcription polymerase chain reaction performed. CaCo-2 cells were inoculated with the specimens containing the SARS-COV-2 genome, and subcultured for virus isolation. After culturing, viral replication in the cell supernatant was assessed.</p></sec>
<sec><b>Results</b>
<p>Of the samples collected from 74 COVID-19 patients, SARS-CoV-2 was detected in 15 serum, urine, or stool samples. The virus detection rate in the serum, urine, and stool samples were 2.8% (9/323), 0.8% (2/247), and 10.1% (13/129), and the mean viral load was 1,210 ± 1,861, 79 ± 30, and 3,176 ± 7,208 copy/µL, respectively. However, the SARS-CoV-2 was not isolated by the culture method from the samples that tested positive for the SARS-CoV-2 gene.</p></sec>
<sec><b>Conclusion</b>
<p>While the virus remained detectable in the respiratory samples of COVID-19 patients for several days after hospitalization, its detection in the serum, urine, and stool samples was intermittent. Since the virus could not be isolated from the SARS-COV-2-positive samples, the risk of viral transmission via stool and urine is expected to be low.</p></sec>
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<sec><b>Objectives</b>
<p>In this pandemic situation caused by a novel coronavirus disease in 2019 (COVID-19), an electronic support system that can rapidly and accurately perform epidemic investigations, is needed. It would systematically secure and analyze patients’ data (who have been confirmed to have the infection), location information, and credit card usage.</p></sec>
<sec><b>Methods</b>
<p>The “Infectious Disease Prevention and Control Act” in South Korea, established a legal basis for the securement, handling procedure, and disclosure of information required for epidemic investigations. The Epidemic Investigation Support System (EISS) was developed as an application platform on the Smart City data platform.</p></sec>
<sec><b>Results</b>
<p>The EISS performed the function of inter-institutional communication which reduced the processing period of patients’ data in comparison to other methods. This system automatically marked confirmed cases’ tracking data on a map and hot-spot analysis which lead to the prediction of areas where people may be vulnerable to infection.</p></sec>
<sec><b>Conclusion</b>
<p>The EISS was designed and implemented for use during an epidemic investigation to prevent the spread of an infectious disease, by specifically tracking confirmed cases of infection.</p></sec>
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<p>This study aimed to observe the initial trend of imported COVID-19 cases in South Korea since the beginning of the outbreak. All imported cases were classified into 5 regions (China, Asia, Europe, Africa, and America) according to travel history and potential exposure to the COVID-19. The list of countries for which confirmed cases had a travel history (single visit, multiple visits) and presented, were used to estimate the potential “exposure countries” of confirmed cases. For better understanding of the overall imported cases, time differences (day) among 3 major steps (symptom onset, entry to South Korea, laboratory confirmation) were measured based on available data. From the first importation of a COVID-19 case on January 20<sup>th</sup>, a total of 171 imported cases have been officially reported in South Korea as of March 23<sup>rd</sup> 2020. The overall trend of importation has significantly changed during this period. Importation of confirmed cases were initially from China, and subsequently from other Asian countries. After that, importation from Europe rapidly increased, with importation from America also increasing. One hundred fifteen (81%) were confirmed within 7 days of symptom onset. One Hundred forty three (84.1%) imported cases were confirmed within a week after entry into South Korea. One hundred seven imported cases (75.9%) developed symptoms within 5 days before or after, entry to South Korea. Streamlined processes of detection, subsequent testing, isolation, and treatment by public health authority, was key in minimizing the risk of secondary transmission.</p>
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